Beam Me Up

Intrigued by a slew of new laser treatments, Francesca Castagnoli—long loyal to her dermatologist’s needle—finally sees the light.

Having a needle stuck into my face has never fazed me. Subjecting my complexion to the burn of a laser, however, is a completely different story. Apparently, I’m not alone; among those of us who seek the antidote to aging at the dermatologist’s office, there seems to be a defined split. There’s the pro-injection party: women who demand immediate results and are not squeamish around needles but who become very afraid when you talk about searing off the top layer of their skin. And there’s the laser contingent: those fearful of having anything injected into their bodies but willing to endure serious pain and a week of hiding out at home in the name of collagen regeneration. “There is definitely a psychological battle between injections and lasers,” says Paul Jarrod Frank, a New York cosmetic dermatologist. And that battle can result in casualties. “What we need to be concerned about is doing too much of either type of procedure,” he cautions. “Ideally, you want a little bit of both, so it looks natural, is safe, and has the least downtime.” I’ve been on Team Injection for years—at this point, I might even be its captain—but Frank’s warning, as well as recent developments that have made lasers more effective and easier to tolerate, got me thinking this might be the moment to play it both ways. Here are the treatments that have me finally seeing the light.

Inside Job

What woman hasn’t looked in the mirror, pulled back her cheeks, and thought, Just a tuck? Dermatologic surgeon M. Christine Lee, of the East Bay Laser & Skincare Center, in Walnut Creek, California, is hoping that the InnerLaserLift, a new procedure she co-developed, will make tightening nasolabial folds almost that easy. Rather than using the laser—in this case, the SP Dynamis by Fotona—on the surface of the face, Lee aims it at the inner cheek, tightening the underlying tissue from inside the mouth. One of Lee’s collaborators, Claudia Pidal, a Buenos Aires–based physician, came up with the technology behind the technique. While researching dental applications for the SP Dynamis, she noticed an unexpected side effect: smoother, tighter facial skin. Working with her husband, Luis Mansilla, a neurologist and laser researcher, she developed a hand piece for the laser that both allows it to be used intra-orally and focuses its energy for maximal penetration into soft tissue. She then reached out to Lee, and to Aldo Toschi, a dermatologist in São Paulo, to develop the treatment, which, assures Lee, is painless: “All you feel is a puff of heat.”

Lee hopes to begin training doctors for a national rollout by next summer. Until then, she is the only U.S. doc performing the procedure. She recommends one treatment for every decade of age, spaced two to four weeks apart. (So if you’re 40, you have four treatments.) The effects can last up to a year, and, based on a small clinical trial, she believes one annual follow-up would be enough to maintain results indefinitely. She’s now using the SP Dynamis hand piece for forehead and brow lifts and to tighten the arms, stomach, and thighs—not to mention more private regions. “This laser is going to make vaginal rejuvenation surgery obsolete, because it’s quick, painless, and has almost no side effects,” Lee says.

Gold Standard

While lasers may be able to tighten even our most intimate body parts, one thing that’s been particularly difficult for them to conquer is acne. Lasers respond to contrast—like sunspots or dark hair against lighter skin. The sebaceous glands that form acne are deep beneath the surface and hardly visible. The solution? “We needed something to get into sebaceous glands that strongly absorbs light—and we realized gold was the answer,” says Dilip Paithankar, PhD, chief technology officer of Sebacia. The company’s innovative procedure, which may get the FDA green light in the spring, involves massaging fine, gold-coated sand into the skin, which is then treated with a hair-removal laser. The gold absorbs the laser’s light, converting it to heat, which renders oil glands inactive. Data from independent clinical studies showed on average a 61 percent drop in inflammatory lesions eight months after treatment. “Acne was still present, but dramatically improved,” says dermatologist Gilly Munavalli, director of Dermatology, Laser & Vein Specialists of the Carolinas in Charlotte, North Carolina, who took part in the trial. Sebacia estimates the cost will be around $500 per treatment, with follow-ups suggested every eight to 12 months. The company also has plans to use its oil-gland-zapping technique to shrink large pores, a common hallmark of older complexions.

The biggest game changer might not be a single groundbreaking technology so much as quick, one-stop access to many treatments.

Invisible Ink

It turns out that removing your ex’s name from your body can be more difficult than the actual breakup. Typically, tattoo removal requires multiple sessions, and fading can plateau with certain inks, leaving a ghost image. But the picosecond laser, often referred to by its brand name, PicoSure, pulses light much more quickly than typical lasers, allowing it to break down ink into smaller pieces, which are easier for the body to absorb. The upshot: cleaner removal in half the time. There is some discomfort involved, but, thanks to topical anesthetic, “it’s not as painful as getting a tattoo in the first place,” says dermatologist Robert Weiss, the director of the Maryland Laser Skin and Vein Institute, in Cockeysville, Maryland.

Happily, the “photo-rejuvenation” facials that doctors are now performing using the same laser are even less ouch-inducing. The Focus Lens Array is an add-on to the PicoSure that redistributes the picosecond beam into hundreds of microbeams to smooth the skin and even out tone. In a study funded in part by Cynosure, the makers of PicoSure, researchers noted that after four treatments, patients had a 50 to 75 percent reduction in wrinkles and hyperpigmentation. On a scale of one to 10, patients reported the pain level to be about a two and needed only two to four hours of recovery.

One-Stop Shopping

The advances in laser science are dramatic, but the biggest game changer might not be a single groundbreaking technology so much as the fact that patients can now have quick, one-stop access to many treatments. Like nail and blow-out bars, laser bars are cropping up around the country. At Pulse Laser & Skincare Center, in New York, the “menu” tackles acne, hyperpigmentation, vascular issues like broken blood vessels, skin tightening, and, of course, hair removal. Its latest express treatment, the 30-to-45-minute Pulse Triple Perfection, delivers a rosy glow by combining an enzyme peel, intense pulse light (to kill bacteria and reduce hyperpigmentation), and the e-Matrix laser (to tighten).

The efficiency of this approach finally persuaded me to give lasers a try. In an effort to treat the one area of my face that injections haven’t been able to reach—the fine wrinkles beneath my eyes—I consulted with one of the Pulse owners, Michelle Moyer, who suggested the e-Matrix Elos, which has a special hand piece designed for the eye area. Oddly enough, my first foray into lasers wasn’t technically with a laser but with bipolar radio frequency, which relies on electrical energy, as opposed to a crystal, to heat the skin, plumping under-eye hollows and stimulating collagen growth. Though quick, the 25-minute procedure is more invasive than the typical lunch-hour treatment—the pain level was around a five and subsided within a few hours, but it took three to five days for the raw redness to die down. Initially, I didn’t see much improvement—and was feeling smug about my faithful allegiance to injections—but two months and two treatments later, my freckles are paler, my skin looks brighter, and those fine lines under my eyes are less noticeable. True, I’m not even close to kicking my needle habit, but I am now convinced of the wisdom of a bipartisan approach.